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Primary Care Today, November 2011 “Training is much more than ticking boxes”

Zoë Elkins, Head of Care Strategy, The Good Care Group, outlines an approach which takes training of carers to a new level.

When training carers in looking after the elderly, ticking boxes to indicate what elements of education have been covered can seem appropriate and adequate.

However, whilst an array of ticked boxes may satisfy regulations, it does nothing to measure what has really been learned and applied.

The Good Care Group, which supports elderly individuals in their own homes, places enormous importance on ensuring that the skills acquired are directly applied to deliver high quality care in the home that results in improved outcomes for the client.

Because of this, we have launched The Good Care Group’s Health and Social Care Professional Apprenticeship scheme. This has been developed in an ongoing partnership with National Training and Qualifications UK (NTQUK) which leads in the delivery of health and social care vocational training programmes in the private and public sectors.

This recently introduced apprenticeship scheme goes much further than what is required for mandatory training provision. It ensures the group’s professional carers are exceptionally proficient at fully supporting elderly individuals, including those living with dementia. Carers completing the apprenticeship programme are rewarded with improved packages linked to their performance and enhanced career prospects.

The programme helps to ensure that staff have clear career pathways – whether their ambition is to provide the highest levels of individual care, to move up to a supervisory or managerial level, or to specialise in a particular type of care –supporting individuals living with dementia, for example.

Through improving their knowledge and skills, the group can deliver high standard care packages for clients whose overall health and wellbeing are positively influenced.

The Good Care Group’s Health and Social Care Professional Apprenticeship has nationally-recognised vocational qualification status and is certified by a leading awarding body. The apprenticeship programme has been created to include the requirements of the Qualifications and Credit Framework (QCF) as determined by Skills for Care.

Carers who successfully complete the professional apprenticeship programme gain the following: Key Skills Certificate in Numeracy, Key Skills Certificate in Literacy, Technical Certificate, Certificate in Employee Rights and Responsibilities, BTEC Certificate in Health and Social Care, and Level 2 or 3 Health and Social Care Diploma.

The Qualifications and Credit Framework covers how all regulated vocational qualifications are structured, titled and quality assured– it replaced, from January 2011, the National Qualifications Framework (NQF) across England, Wales and Northern Ireland. The QCF is a new way of recognising skills and qualifications, with credits awarded for qualifications and for units or small steps of learning. The new system enables individuals to obtain qualifications at their own pace in a flexible manner.

We consider that working with NTQUK will significantly contribute to the success of the apprenticeship scheme. NTQ UK believe our scheme is at the forefront of care providers in the UK, and that we have risen promptly and decisively to the challenge put before employers to design and deliver appropriate training in the care sector.

Our carers work autonomously, so their training must be both comprehensive and flawless. People are recruited with the potential to be highest quality carers and they must be able to work independently – after all, poor practice cannot be identified in the way it can in a care home.

We believe that the statutory minimum training for carers is basic and too loosely defined. It is not sufficient to focus on subjects such as health and safety, risk management, moving and handling, and food safety and to state that these areas have been covered in training sessions.

After all, staff are caring for human beings, not stacking supermarket shelves and it is essential to make sure ‘softer’ subjects, such as having empathy with the people cared for and being able to build effective relationships, are given appropriate prominence.

Our view is that it is necessary for carers to have an understanding of conditions which may present in the individuals for whom care is provided. Indeed, such understanding must be in place if the carer is not to do the job by rote, but to be responsive to an elderly person’s changing and new needs.

The group’s induction training programme takes the form of an intensive, fully-funded, six-day residential course – we think requiring trainees to pay for their course is the opposite of motivational. Participants stay in a hotel and receive training in a bright, comfortable setting from a trainer who is engaging, encouraging of interaction and who inspires staff, reminding them of why they chose to be carers and the importance of their role.

Participants do not have the stress of commuting to the course and can relax in the evenings, developing important bonds with colleagues. The training is closely focused, but there is no structured instruction in the evenings – however, ‘training’ tends to continue as those on the course reflect on what has been discussed during the day.

The induction programme focuses on practical instruction rather than theory and throughout the course learning is applied to a fictional case study centred on a typical client. This helps participants apply the knowledge they have gained to the person

Time is set aside during the induction programme to study an e-learning facility designed to continue participants’ education for a three-month period following the course. Having the e-learning extension to the course avoids an instruction overload in the intensive six days of the residential programme. The fully interactive e-learning facility features self-assessment.

In the first two weeks of placement following the induction course, the carer and client are visited by a supporting manager, who will provide intensive, tailored, assistance to ensure the needs of both the carer and the person for whom care is provided, are comprehensively met.

Through raising levels of knowledge and skills of carers, care packages for clients are improved so that their health and wellbeing are positively enhanced. This enhancement is derived from the way in which carers are fully supported in their career and are motivated and engaged in their placements.

A carer’s smile and an air of confidence is conducive to a client relaxing and trusting in the care path being provided. The training enables the carer to be responsive to the needs of the individual for whom care is provided. These needs may change not just by the week or day, but by the hour. A carer, properly trained will be able to recognise when an element of a diet should be changed, when the intake of fluids should be increased and when more time should be spent in listening and discussion.

Our professional apprenticeship programme is unique because of its comprehensiveness and scope. We have in place some of the latest communications technologies to enhance efficiency in distance learning and procedures to monitor progress with the programme, so that elements are continuously reviewed and refined.

Carers are provided with smart phones with which they access emails and voice messages. Calls between carers are free of charge, encouraging discussion and comparison of applying care techniques. An online forum for carers is planned.

Carers continue to participate in regular one day training sessions, as they work their way to their qualifications.

The training progress of each carer is closely mapped, with task learning demonstrated and logged. The individual carer builds a portfolio of knowledge subjects and this is valid in the care sector whether or not the apprenticeship scheme is completed.

Seven members of a pilot group of apprentices have recently completed the apprenticeship programme and feedback from participants, whether new to the caring sector or having many years of experience, has been consistently positive. A second group, with 18 participants, has now embarked on the next apprenticeship programme.

The Good Care Group is also stepping up its specialised care package for individuals living with dementia, and has developed a two-month advanced level training programme for carers delivering this package. Each course within the programme will have a maximum of 15 participants, and will feature two intensive days backed up by continuous monitoring and assessment. Course participants will be in placements supporting individuals with dementia, so that they can continue to live in their own homes, and will bring to the course their experiences of these placements. They will share such problems , including how to cope with an individual who regularly is up and about wandering in the early hours of the morning, or who refuses to take medication –and how to find solutions to these.

The training is in a workshop format with interactive and role playing sessions fitting into structured skills development. Carers’ knowledge and skills are considerably improved, with direct and immediate benefit to clients.

The advanced level training programme for carers, supporting those with dementia centres on the Specialized Early Care for Alzheimer’s (SPECAL) approach. This focuses on using intact memories, often from many years ago, to help in creating a feeling of wellbeing. The SPECAL Photograph Album is an analogy likening the memory system to a compilation of photographs and provides a way of assisting carers to gain an understanding of the way normal memory works, what happens with age and the significant change occurring with the onset of dementia.

The SPECAL method enables an individual with dementia to bring to the fore memories which are then used as virtual frameworks on which to overlay current contexts. Using SPECAL Observational Tracking (SPOT), it is possible to identify which cues, objects, phrases and gestures the person with dementia associates with particular situations and actions. Verbal communication is usually backed up with gestures which are often ignored –those caring for people with dementia have to recognise and be responsive to non-verbal communication.

In raising the bar with our training, I believe we are significantly improving the career paths of staff, making positive steps to professionalise care and enhancing the care packages for the people who we look after.

More information about The Good Care Group is available at www.thegoodcaregroup.com

01 November 2011

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